RAGWEED ALLERGIC RHINITIS AND THE PARANASAL SINUSES - A COMPUTED TOMOGRAPHIC STUDY

Objective: To explore the potential association of allergic rhinitis a nd sinusitis. Design: Prospective clinical trial. Setting: Academic te rtiary referral center. Participants: Ten subjects with symptomatic ra gweed allergy during the peak of the ragweed season. Main Outcome Meas ures: We obtained a paranasal sinus computed tomographic scan on all v olunteers and had them complete a modified Rhinitis Quality of Life Qu estionnaire. All subjects were then treated with intranasal aqueous be clomethasone dipropionate (168 mu g twice a day) and completed the Rhi nitis Quality of Life Questionnaire weekly until the end of the study. Results: Six of 10 of the subjects had sinus mucosal thickening on co mputed tomographic scan. All subjects improved symptomatically. A seco nd computed tomographic scan was obtained after the pollen season in 5 patients with mucosal abnormalities, while the patients continued tre atment with intranasal steroids and symptomatically improved. The sinu s mucosal abnormalities persisted in all patients. Conclusion: Despite the 60% incidence of abnormalities on the computed tomographic scans of the subjects with ragweed allergy during the season, these abnormal ities appear, at most, to contribute minimally to the patient's sympto ms, since resolution of symptoms was not accompanied by a reduction in sinus mucosal abnormalities.